tag:blogger.com,1999:blog-26666124.post9119457747430614265..comments2015-03-31T11:11:45.433-04:00Comments on Shrink Rap: Clink RespondsDinahnoreply@blogger.comBlogger5125tag:blogger.com,1999:blog-26666124.post-26260461384849102712009-01-04T13:51:00.000-05:002009-01-04T13:51:00.000-05:00I'm the anon, and, yes, that answers my questions....I'm the anon, and, yes, that answers my questions. Particularly interested in the discussion of the need to take into account the dispersal of prescriptions into the general population. <BR/><BR/>And I'm surprised to learn that you wouldn't have info on a prisoner's key dates ... I'm guessing that means you don't get the records on those, but might ask the patient about them in some circumstances? I mean, my therapist and I would talk about when layoffs were coming at work, or such.<BR/><BR/>I take your point about the unreliability of the information you're given about prior treatment. It does remind me, tho, of the time I ended up in a hospital that also took in most of the general trauma cases in a city notorious for its crime. It was my impression that the doctors and nurses were so used to working with less-than-savory patients that their hardened attitude affected their treatment of everyone. For example, it took some doing to persuade them that my request for a transfer to a different room wasn't some sneaky way to get a private room, but a desire to not be in the same room with another patient who was conducting drug deals from his bed. You've probably addressed this previously: How does a clink shrink keep from developing a shell that assumes every patient is a lying jerk? <BR/><BR/>Finally, I'm sorry for the poor wording of the first question -- certainly, I knew you wouldn't be able to comment directly on this case; rather, it was a general question, which your answer did address.<BR/><BR/>Thanks for this.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-47827544860265306162008-12-25T09:01:00.000-05:002008-12-25T09:01:00.000-05:00It's only one side of the story, but this makes ho...It's only one side of the story, but <A HREF="http://gaycitynews.com/site/news.cfm?newsid=20202796&BRD=2729&PAG=461&dept_id=568860&rfi=6" REL="nofollow">this</A> makes horrific reading.<BR/><I>Writing for the three-judge panel of the state's 1st District Court of Appeal, Judge James A. Richman found that despite the precedent in numerous courts in other states that a jailer has a duty under tort law to protect vulnerable prisoners from attack, there was none in California, which caused the trial court to dismiss the negligence claim.<BR/>...<BR/>Giraldo self-identifies as a "male-to-female transgender person," according to Richman's opinion. Although she was recommended, at the time she was taken into custody, for placement at the California Medical Facility or the California Men's Colony, institutions with experience in handling transsexual inmates, where they "are relatively safer... than at other state prisons," she was sent to Folsom and put into the general male population.<BR/><BR/>There, another inmate employed as a lieutenant's clerk requested that Giraldo be assigned as his cellmate, and according to Richman, "beginning almost immediately, and lasting through late January... 'sexually harassed, assaulted, raped, and threatened' plaintiff on a daily basis." Soon, she was passed along to the cell of her attacker's friend, who soon "began raping and beating her, again daily." Although Giraldo reported this abuse to prison officials and begged to be transferred to a different cell, her requests were ignored for several weeks.<BR/><BR/>She was only moved to "segregated housing" after suffering a rape and attack with a box-cutter by her cellmate in mid-March, just days after a prison counselor advised her to be "tough and strong" and discouraged her from making any further complaint. A medical officer who spoke with Giraldo two days before the rape and box-cutter attack noted the conversation in her file but took no steps to report her pleas for help to authorities, because "I don't want to get him into trouble."<BR/><BR/>Giraldo was moved to a unit for psychologically troubled inmates, but lived in constant fear that she might be sent back to the general population and placed with another abusive cellmate. She was released on parole after filing her lawsuit, shortly before the trial on her claims was to take place.</I><BR/><BR/>Given what happened to her, I wouldn't be surprised if she was rather more than merely "psychologically troubled".<BR/><BR/>There's also <A HREF="http://www.jsonline.com/news/milwaukee/29327009.html" REL="nofollow">this one</A>:<BR/><I>"Earlier, Kevin Kallas, a psychiatrist and mental health director for Wisconsin's prisons, testified he opposed the law banning hormones.<BR/><BR/>Besides in federal prisons, hormones are given in all of the Midwestern states surveyed by the Department of Corrections, he said. Kallas called hormones a "medically necessary" treatment in some, though not all, cases.<BR/><BR/>Kallas said patients who are taken off hormones typically need counseling, drugs and hospital stays instead, suicide treatments that are more expensive than the hormones, which cost $675 to $1,600 a year. Kallas said he did not know of any other medical treatment that the state Legislature has banned in prisons."</I><BR/><BR/>Necessary medication is banned, even though it costs more to deal with the resultant deaths and lesser sequelae than the medication would cost.<BR/><BR/>One can always locate individual horror-stories of experiences in jail. But this appears to be a systemic problem, even in correctional facilities which are otherwise orderly, and not one confined to the USA.<BR/><BR/><I>December 1997. After an appearance in a Local Court, bail was refused and Ms M. was remanded in custody. Late on 22 December she was transported to a remand and reception centre where that night and into the morning of December 23 she underwent induction assessment. She was identified as transgender by the welfare officer and it was determined she should go into a “protection” wing. Having spent December 24 in court Ms M. spent December 25 and 26 in “strict protection”. During this time she was brutally raped at least twice during daylight hours. The attacks were so vicious that two other prisoners took the unusual step of reporting the incidents and giving sworn evidence. On December 27 Ms M. was found dead in her cell hanging by a shoelace.</I><BR/>- Inquiry into a death, Coroner J Abernethy, Wednesday 21 July 1999. Ref: <A HREF="http://www.aic.gov.au/publications/tandi/ti168.pdf" REL="nofollow">W308 201/99 JI-D1</A> (PDF).Zoe Brainhttp://www.blogger.com/profile/13712045376060102538noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-3633324743355933832008-12-24T18:35:00.000-05:002008-12-24T18:35:00.000-05:00Fascinating post on a subject I've never really gi...Fascinating post on a subject I've never really given a lot of thought to. Thanks for sharing your insight and experience.NurseExechttp://www.blogger.com/profile/07951250862147784757noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-16791310268154951592008-12-24T15:44:00.000-05:002008-12-24T15:44:00.000-05:00Great post Clink Shrink! It gave me insight I did...Great post Clink Shrink! It gave me insight I did not have previously on the special challenges that you face. It particularly had not occurred to me that what you prescribe for one inmate will fall into the hands of other prisoners. I'd think "someone" would give them the med and watch while they swallow it, but I guess there aren't resources for that.Therapy Patientnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-12594747688017158622008-12-24T13:37:00.000-05:002008-12-24T13:37:00.000-05:00Excellent point re diagnosis with little data. Two...<I>Excellent</I> point re diagnosis with little data. Two problems I believe are endemic to "forensic" diagnosis in CA: medical records are <I>brimming</I> with "self-report" without any clinician's attempt to corroborate. Rarely does it caveat with "pt <I>reports</I>..." <BR/><BR/>Just <I>one</I> example: I have yet to figure out how to evaluate for head injury. If I outright <I>ask</I>, 7 out of 10 report an historical (M)TBI, and 3 out of 10 claim a seizure. OK, this is a "high-risk" population, but is it statistically possible? Recorded in the chart, "TBI with LOC, seizure, and coma for 3 days." Data source? Ultimately, inmate self-report. I see nothing that would suggest a cognitive or neurological deficit. The chart indicates a history of seizure meds. Data source for prescribing? Ultimately, inmate self-report. The truth? Slim <I>and</I> shady.<BR/><BR/>In general, the persistently mentally ill are notoriously poor reporters of history. But they don't usually purposely attempt to deceive. Ah, <I>malingerers</I>, the bete noir of prison psychiatry. And I must say, the benefits of taking high side-effect, potentially harmful meds from an inmate's perspective, are "understandable."<BR/><BR/>So where does this leave you? Do what's clinically <I>prudent</I> with the information you have and hope for the best? As I found, you are likely to have a few shots, because they'll probably be back. You have my respect, Clink. It's a very, very difficult expertise that seems to me to walk the fine line between hope and cynicism.FooFoo5http://www.blogger.com/profile/06459026418242101033noreply@blogger.com